Change to start collection at accept rather than arrive time

At least some of these started, but does someone know when this actually got implemented?

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mixed bag, not yet broken out, copied from Task meetings

• For Medicine and ICU patients we begin our record when our service takes over care, NOT when the patient reaches their designated “home” location. This means that procedure codes, and counts of things (e.g. transfusions) will start when our service takes over, including any/all time spent on that service (e.g. time in ED or PACU, or other “boarding” location).

For ICU patients we will decide on a Minimum data set of TISS items to be collected when patients are boarding. These will have to be recorded by collectors. Of note, Tina reports that the DSM data we’re getting DOES include labs from the time in ED, so she will simply need to include the lab data from the time when our service takes over care. Regarding the “machinery” for this -- discuss next time expanding the “Boarding Location” machinery to initial admission and all moves thereafter. In this schema, the name would be changed to something like “Physical Locations”, and the initial one would be wherever the patient was when he/she first began to be cared for by the service/team. This machinery can then easily be used by Julie to report on boarding, lengths of stay and every other aspect of location and timing of care. Because such moves are much more frequent and confusing for Medicine than ICU, as suggested by Michelle, for Medicine patients we would have only 3 possible physical locations: ED, their service location, or a generic boarding location which is not further subdivided. We began to discuss that with the above changes, and the increased boarding that will likely become the norm, it would be simpler to keep track of database records not as we do now (i.e. by home location) but rather by home service. The machinery discussed above will allow Julie to write SAS code to slice and dice the information in any way desired -- e.g. time in each physical location (including high obs). After we discuss this more next time, Allan will talk to Drs. Renner/Hajadiacos if they see any major problems with such a change in process. Allan confirmed that Hajidiacos is fine with this. Ttenbergen 12:01, 2020 October 27 (CDT)

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The following needs to live somewhere, but I can't figure out where it needs to go right now, so leaving it here for now. Does the following also go for STB_ACCU ? STB_CICU special case STB ICCS/CICU Cardiac Surgery patients will have an Accept DtTm starting when the pt. arrives in the ICU. If a Cardiac Surgery patient is accepted back to the ICU after they have already been transferred to the ward (CR4), then the accept time is when the ICU has agreed to take them to the ICU, and they are considered a boarded pt. from that time (TISS will be required for the boarded time)

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TISS

need a way for collectors to enter pre-arrive TISS data - or do we?

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ADLs

See question at ADL General Collection Information#Timeframe

GCS

See question at Glasgow Coma Scale.